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Cardiopulmonary bypass induces leukocyte-platelet adhesion
CS Rinder, JL Bonan, HM Rinder, J Mathew, R Hines and BR Smith
Department of Anesthesiology, Yale University School of Medicine, New
Haven, CT 06510.
Cardiopulmonary bypass (CPB) has been demonstrated to activate platelets,
producing an increased number of circulating platelets that have undergone
alpha-granule release and express granule membrane protein-140 (GMP-140) on
their surface. In vitro, GMP-140 mediates activated platelet adhesion to
neutrophils (PMN) and monocytes, causing the formation of
leukocyte-platelet conjugates. Using a newly developed assay that measures
the percentage of circulating leukocyte-platelet conjugates in whole blood,
we studied 17 patients undergoing CPB and have determined that (1)
monocyte-platelet conjugates increased significantly during CPB, from 18%
+/- 1.5% to 44% +/- 4.5% (mean +/- SEM) by the end of CPB, while
PMN-platelet conjugates increased only slightly and lymphocyte-platelet
conjugates decreased; (2) the time course of the increase in monocyte- and
PMN-platelet conjugates paralleled that of the increase in circulating
activated platelets, as determined by the presence of surface GMP-140; and
(3) monocyte activation, as assessed by increased surface expression of
CD11b, showed a gradual increase similar to the increase in
monocyte-platelet conjugates, while PMN surface CD11b peaked immediately
after the start of CPB. We conclude that CPB, through increased platelet
GMP-140 expression, causes formation of monocyte-platelet, and to a lesser
extent, PMN-platelet conjugates. The activation of monocytes and PMN on
CPB, as evidenced by CD11b expression, occurs with differing time courses.
Volume 79,
Issue 5,
pp. 1201-1205,
03/01/1992
Copyright © 1992 by The American Society of Hematology
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